NPO Nagasaki Expert Group of Dysphagia, Sasebo, Japan.
Sasebo-Yoshii Community Comprehensive Support Center, Sasebo, Japan.
Australas J Ageing. 2024 Jun;43(2):369-375. doi: 10.1111/ajag.13310. Epub 2024 Mar 27.
The development of a dysphagia screening test is an urgent issue in the field of frailty prevention among community-dwelling older people. The purpose of this study was to evaluate the screening performance of a 100-mL water swallowing test (WST).
The study employed a cross-sectional design. Participants were 304 (65 men and 239 women, mean age = 80 years) Japanese community-dwelling older adults aged over 65 years. We investigated swallowing disorder using the 10-item Eating Assessment Tool (EAT-10), and compared choking signs, swallowing time and number of swallows, and their combination in the 100-mL WST. We calculated the sensitivity and specificity of these indices. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value of swallowing time and number of swallows in the 100-mL WST based on the Youden Index among participants without choking signs.
The sensitivity and specificity of choking signs in the 100-mL WST were 20% and 91%, respectively. The discriminating ability of swallowing time and number of swallows among participants without any choking signs was .76 and .72, respectively, in the area under the ROC curve. Diagnostic sensitivity and specificity to discriminate dysphagia from normal swallowing ability were 65% and 74% when the cut-off was >10 s based on maximisation of the Youden Index. The 100-mL WST performed best when the indices of choking signs and swallowing time were combined, with a sensitivity and specificity of 72% and 68%, respectively.
The 100-mL WST would be an adequate screening tool when compared to the EAT-10.
开发吞咽障碍筛查测试是预防社区居住老年人衰弱领域的一个紧迫问题。本研究旨在评估 100 毫升水吞咽测试（WST）的筛查性能。
本研究采用横断面设计。参与者为 304 名（65 名男性和 239 名女性，平均年龄 80 岁）日本社区居住的 65 岁以上老年人。我们使用 10 项饮食评估工具（EAT-10）调查吞咽障碍，并比较了 100 毫升 WST 中的呛咳征象、吞咽时间和吞咽次数及其组合。我们计算了这些指标的敏感性和特异性。根据无呛咳征象参与者的约登指数，使用受试者工作特征（ROC）曲线分析确定 100 毫升 WST 中吞咽时间和吞咽次数的最佳截断值。
100 毫升 WST 中呛咳征象的敏感性和特异性分别为 20%和 91%。在无任何呛咳征象的参与者中，吞咽时间和吞咽次数的鉴别能力分别为 ROC 曲线下面积的 0.76 和 0.72。当截断值基于约登指数最大化时，区分吞咽困难和正常吞咽能力的诊断敏感性和特异性分别为 65%和 74%。当呛咳征象和吞咽时间的指标结合使用时，100 毫升 WST 的性能最佳，敏感性和特异性分别为 72%和 68%。
与 EAT-10 相比，100 毫升 WST 是一种足够的筛查工具。
